HomeMy WebLinkAboutBuilding Permit Application ALL APPUCABLEliINFO MW BE COMPLETED FOR APPLICATION TO BE ACCEPTHI c�
Date: �li/ PermitNumber.
RECEIVED
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Building Permit Application SEP 10 ?018
Planning and DevelopmentSeivkes 5T. Lucie County, Permitting
Building and Code Regulation-Divtsion
23W WrgiiriaAvenue,FoitRerve FL 34992
Phone:(772)4621553 Fax:1772)4621578 -Commercial Residential
PERMIT APPUCATION FOR: To Select from dropbox,dick arrow at the end of line
OROPOSED IMPROVEMENT GOCATiQN
Address: /� a(4 CC 1`
Legal Description: aq fqt S L4, r c/ 6, -,3 ;(-,3f Th
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PropertyTailD#: _f , �lti—,�V " �� r��, C Od Lot No.
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Site Plan Name: Block No.
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:Project Name.
Setbacks Front Bade Right Sidev- Left Side:
DETAILED_DESCRIPTION OF 1NORK::
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CO INI=ORIIIIATION..:_ _
Additional work to b e e rme under - is perm –c a app .
l�JHVAC -13Gas Tank [DGas Piping Shutters O windows/Doors
[JEledric 0 Plumbing 11prinklers. OGenerator Roof
Total Sq.Ft of Co sawim-1 n: Sq.Ft of First Floor.
Cost of Construction:$ Z y0 i Utii-itiesSewer USeptic Building Height: /
OWNE.R/EESSEE �CClNTRACTOR..
Name ' S AName:
r�
• Address: d _r/1C(/K A.e- Company: fi r
Qr- Address: Z C l�
Zip Code S Fax; C, —
�-Y State: /CC•-
Phone Luo. 7 .Y i3 lJ�- - ��h�`� -
---- Zip Code:,3 f'7 5';I""" t Fax: ??�-"'���2r�pff
E-Mail= A Phone No.
Fill in flee simple Tide Holder on next page(if dHfierertt E-Mail: to Q
from the Owner listed above) State or Cou -cense:
If value of construction is$2500 or mare,a RECOMM Notke of Commencement is required.
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DESIGN ENGINEER: Not Applicable MORTGAGECOMPANY: Not Applicable
Name: Name:
Address: Address:
Mr. Stater City: —St ate:
Zipr Phone: Zip: Phone:
FEE SIN u TITLE HOLDER:- ' Not Applicable BONDING COMPANY: Not Applicable
Name: - Name-
Address: Address: '
Cityr, -
zip., Phone: ZiP= Phone.
Ian*that no vrork or hrstal[Won has commenced prior to the bsuarrce of a perp it
ala �rrt�r�no ce�ppreser ll on#hatisgranting a�will es a orizethe permit holderto lw�i ft subject structure
strucW&Pimmcorr�tt1:14olurpHtomeO vnersmon andrutrediw urdeedllbraasyc o wh m4appy prohibit such
In consideration ofthe granling of this requested permit,I do herektagree that i will,in all respects,perform the work
m aaoordimcewith the approved plans,the Florida Building Codes and St.luciecounty Amendments.
?h e"owftbillOW permit apptha OM are exmnptf m undeWbW a full Concurrency renew.room addition%
accessory structures,swiimu ft pools,fences,walls;stgn,scremn. cinami accessory uses to another non-rtwdential use
WARNING TO OWNER:Yaw faihm to Record a Notive of Commencement may result in Your,+oa►t twice for
impprovements to your propeA Notice of Commencement must be recorded and pasted on the jobsite
beforty.re the first Inspection,If you intend to obtain finar edn&consult with lender or an attorney before
commgog work or recording our Notice of Comment eMe
re of Agent/Lessee of CanYraftrAkenie Holder
STATE OF FiARIQA L� �� STATE OF A
CaufnYOF �c. C+OUNWOE
"Thef aftinstrumentwacsadcnolAt me Th�()
hrg� befixeme
ths�dw of a Q _ -i� y a � dW of .20 by
(Name of ."...■'_" ""�'
P } Name of person adkrxrs1 1 } .
YY ■ I�IIIY�1.1�1��.■��w■y
(Signature o Notary Public- of Florida) (S re of Notary biic-State Of"drida}
Person*Known OR Produced Idenfkadon Personally Knownµ OR a civ
Tw of tdentificatton Produced I-A
GLANS ,r`iipX:`'' Y COMMiSS�' 4
conur�sion No. ss`�� � R�ti oar = '
N#GG 022 �issian No: - PtREs:De��f��t-enurtf:: :,
p ,r MY coMM1SS10gondedThru NotaN
DO_. Undeswrit�ts * FO;, •• :-- ---�'
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REVIEWS - FRONT ZONING SUPERVISOR PLANS VEGETATION SEATUR11E MANGROVE
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